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I o.Te necerveo eHO LOG MuneU <br /> g))JL- I C. 1\ /?SAN;JOA" '-IIN COUNTYPUBLIC HEALTH SERV'is <br /> , EI WIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR 3 <br /> APR 0 3 2003 STOCKTON CA 95202 <br />�. (209)468-3420 , -- <br /> NVIRONMENT HERUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT f �� fl [/lam /BU91NE�991�PG�ENCY /1�� EIA) �S{/n����.�pY�T�?��2 <br /> ADDRESS �{�b.3 1nPocr ��'1T1 CG: <br /> PHONE FACSIMILE <br /> f TENTATIVE"APPOINTMENT DATEE'�O3 TIME �(2j4_— <br /> (Please give 710 10 buslneec Gays from date of appllr,atlon Submit0l) Mi <br /> ���HECK BOX TO EXPEDIT_REQUEST-$00.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS Lik <br /> SIGNATURE OF APPLICANT _ DATE �]� ��� <br /> =1LE ADDRESS _ TNIS 310E EN[)STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Ir <br /> —. <br /> ✓ rh -Lap- <br /> ENVIRONMENTAL <br /> UENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(US'')CLEANUP SITE(LOP) O HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> O OTHER CLEANUP SITE(NO 4-LOP) 0 FOOD FACILITY O SOUD M1'A5TE VEHICLE <br /> ! UNDERGROUND TANK(MO VITORINGIREMOVAL) O DOG KENNEL O DAIRY <br /> O HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> O TIERED PERMITTED I n O MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> O TATTOOIBODY PEIRCING O POOUSPA - O LAND USE APPLICATION SITS <br /> O MEDICAL WASTE FACILITY O NNINNIN1101011110M 0 OTHER IPLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the typelsl of files from the list above by checking <br /> the appropriate box(es). At feast One file type MUST be selected. Fax to2091 464.0138 or mall t0 the ' <br /> address Indicated above, <br /> 2. EHD will notify :he applicant if any EHD files exist- An appolirment for review will be confirmed <br /> approximately five business days but no later than ten(10)daps after receipt of application" The files <br /> will be held for A maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not ties Immediately available <br /> i application mal-be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD statjf aIt -` <br /> of the applicant. Future rile reviews by the same applicant may require a $89.00 dellosit prior to review. <br /> 5. -TENTATIVE ap pointment dates must be confirmed with EHD rtaff. <br /> 6. Applications ro:eived after 3:00 pm will be processed the nex:business day" -- <br /> CONFIRMED APPOIN"MENT DATE TIME _ — <br /> 1 <br /> DATE CONFIRMED PHONE FAX IPIITIALS <br /> REVIEWED YI:S NO REVIEW DATE <br /> ETI n4 <br /> i <br /> I 04/03/03 THU 13:20 ITX/RX NO 96021 Cd1002 <br />